Employment and mental health

Briefing 2
‘Mental ill health presents
a major challenge to the
well-being of our society
and the strength of our
economy. It blights lives,
traps people in poverty
and prevents the country
harnessing the talents
and potential of hundreds
of thousands of people.
Government is determined
to lead the way in meeting
this challenge.’
Working Our Way to Better Mental Health:
a framework for action

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B R I E F I N G 2 – E M P L O Y M E N T A N D M E N TA L H E A LT H

THE GOVERNMENT IS committed to addressing the links between

employment and mental health, both for people with mental health
conditions who struggle to find and keep employment and for the
general population, to improve general well-being and increase
employment outcomes.

Work is known to be good for mental health and to aid recovery,

even for those with the most severe conditions. Unemployment is
known to be bad for mental health and the longer people are out of
the workplace, the harder they find it to return and the greater the
impact on their health and well-being.

The government’s strategy to address mental health and employment

is set out in four key documents.

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B R I E F I N G 2 – E M P L O Y M E N T A N D M E N TA L H E A LT H
Working Our Way to Better Mental Health:
a framework for action
W O R K I N G O U R WAY T O B E T T E R M E N TA L H E A LT H aims to:
– improve well-being at work for everyone, and
– help people with mental health conditions find work, stay
in work and return to work more quickly following sickness
absence.
It sets out what the government Departments of; Health, Work and
Pensions, Business, Innovation and Skills, and Children, Schools and
Families, the Cabinet Office, the Health and Safety Executive, and the
Scottish Government and Welsh Assembly Government should do,
jointly and individually, to:
– Change public attitudes to mental health.
– Improve health and well-being in work for the whole
population.
– Ensure swift intervention when things go wrong.
– Provide co-ordinated help tailored to individual needs to
improve health and well-being in and out of work.
– Build resilience from the early years and throughout people’s
working lives.
– Coordinate action across government to ensure success.
‘A modern economy cannot afford such waste of individual talent
nor the high welfare costs.’
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Case Study
‘My client had been signed off with a stress-
related illness for six weeks before being
referred to me by the psychological therapy
team. He was very agitated, had started to
obsess about things and couldn’t sleep.
‘I arranged a meeting with his employer
where we talked about workplace issues and
agreed solutions. We also agreed that when
he felt ready, my client would have a phased
return to work at a different site.
‘My client is feeling much happier and is
back working full-time hours. I support
him with problems as they crop up but
I’m reducing contact where possible
to encourage him to deal with matters
independently. I also worked with his
employer to discuss implementing job
retention strategies throughout the rest of
the company.’
– Jobs in Mind employment support
provider, Improving Access to Psychological
Therapies service
Realising Ambitions: better employment
support for people with a mental health
condition

REALISING AMBITIONS IS an independent review commissioned Case Study: Mary’s story

by the Department for Work and Pensions to explore how welfare
to work services and mental health services could better meet the
employment support needs and aspirations of people with mental
health conditions.
It says that:
– many people with mental health conditions can use existing
mainstream welfare to work services
– some people with a mental health condition will need specialist
support to find and stay in employment
– a large number of people in between these extremes could be
helped if there was greater capacity within existing structures
to meet their specialist mental health needs.
It calls for government action to improve knowledge and
understanding of mental health issues among employers and
employees in the workplace in general in order to make employment
more accessible and possible for those with a mental health condition.
‘I experienced psychosis when I was a
teenager. I self-harmed. For 12 years I was
not able to engage in society. Hospital
was frightening and nightmarish. Then I
started receiving therapy at home from the
community mental health team. Eventually
I developed the confidence to get back into
society. I started volunteering at a mental
health centre and eventually got back into
employment. It was a horrendous journey.
Having a background in business and a
supportive family helped me return to work.
‘Service user’s problems in returning to
work partly come from their own low
expectations, as well as service providers’
low expectations. But with support you can
climb mountains.’

It also recommends the implementation of Individual Placement and

Support (IPS) in Great Britain by placing Employment Specialists in
mental health teams and by easing the transition from unemployment
to work, by the provision of time-limited internships and by modifying
Access to Work.

there should be more effective

R E A L I S I N G A M B I T I O N S S AY S
monitoring of employment rates among people with mental health
conditions both by health and social services and the DWP, in order
to close the gap in employment rates between the general population
and people with mental health conditions.

‘People with mental health conditions remain among the most

excluded within our society. And nowhere is this exclusion more
evident than in the workplace... a combination of prejudice and
discrimination, low expectations and failure to provide the necessary
support continue to deny many people with mental health conditions
the opportunity to work. ‘

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B R I E F I N G 2 – E M P L O Y M E N T A N D M E N TA L H E A LT H
Work, Recovery and Inclusion: employment
support for people in contact with
secondary mental health services
Work, Recovery and Inclusion sets out guidance on best practice in
employment support for people in contact with secondary mental
health services. It has cross-government backing from the Department
of Health, the Cabinet Office, the Department for Business, Innovation
and Skills and the Department for Work and Pensions.
The key messages in Work, Recovery and Inclusion are that:
– Work is good for everyone’s mental health and is central to
recovery for people with mental health conditions.
– Health and employment services must work together to deliver
support to enable people to achieve stable employment.
– Employers should feel confident and supported to employ and
maintain people with mental health conditions in the workplace.
– Those working with people with mental health conditions should
do more to raise their employment aspirations.
– Employment should be considered within the context of the
wider determinants of social exclusion such as housing transport
and debt.
– People who use services should be engaged and involved at the
heart of policy development at all levels.
– Service developments should be based on evidence and data,
and new innovations should be evaluated.
– Services should be tailored to meet the needs of all people with
mental health conditions, regardless of age, gender, disability,
ethnicity, sexual orientation, religion or belief.
Its long-term goal is to radically increase the number of people in
contact with secondary mental health services in employment by 2025
and to narrow the gap between their employment rate and that of
disabled people generally.
It sets out what the government and the relevant government
departments are already doing and will do to ensure people with
serious and severe mental health conditions are supported to find
employment. Actions include:
– greater importance to be given to people’s employment needs
and aspirations within mental health services
– improved specialist mental health employment support
programmes and capacity within JCP
– advice and support for employers to improve health and well-
being generally in the workplace and special provision for people
with mental health conditions, as required by law.
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Case Study: Barry’s journey
Barry lives with his wife, is highly educated,
has a good social network, enjoys composing
music and plays in a band. He has been
unwell for approximately 10 years with a
diagnosis of Dysthymic Disorder, a form of
depression.
Barry’s mental ill health has often had a
negative impact on him being able to sustain
employment.
Barry started working with a Jobs in Mind
Support Advisor after being referred by his
Consultant, who initially requested help to
enable Barry to fi nd paid employment and
to gain structure in his life. Barry wished to
take things at a slow pace initially, drafting
a CV, looking for part time employment and
a Web Design course. After identifying a
vacancy at the local Garden Centre, Barry
asked his Support Advisor to meet with the
Garden Centre manager prior to interview
and talk through his situation. Barry then
attended the interview with the support of
his worker and did extremely well; he was
offered a job there and then and given a
start date.
Barry started work at the Garden Centre at
the beginning of 2009 and is currently doing
very well and enjoying the experience. His
Support Advisor continues to offer support
and guidance until such time as it is no
longer needed, although Barry is able to
draw on further support down the line if
any difficulties arise and his employer can
continue to stay in contact with Jobs in Mind
for support. Barry has also started a Web
Design course.
New Horizons: a shared vision for
mental health

NEW HORIZONS IS a cross-government programme of action for
improving mental health and well-being among the population in
general, across all ages, including those with mental health conditions
in particular. It follows on from the National Service Framework for
Mental Health. It sets out the areas of responsibility and actions in
place and to be initiated by the various government departments
concerned to promote, safeguard and improve mental health and
well-being across the whole population and the lifespan.
‘New Horizons will help us tackle stigma,
personalise services and move forward into
a modern, preventive approach to mental
health and wellbeing. I want to see those
with mental health problems supported
to lead active and fulfilling lives, and this
means an end to the taboo surrounding this
very common health problem.’

Employment is one of the key themes addressed under ‘Better Mental – Phil Hope, Minister of State for
Health and Well-being in Adulthood’. This highlights the mental and Care Services
economic benefits of employment for individuals and for the national
economy, the risks of mental ill health associated with unemployment,
and the role of government, employers and employees in helping
people with mental health conditions to find and keep work,
particularly at times of economic difficulty.

Together these four reports set out a comprehensive, cross-

government package of measures that will both improve employment
opportunities and support for people with mental health conditions
and improve the mental health and well-being of working age adults.

‘Action of employment and mental health must be a long-term

commitment. The wider aim of this comprehensive programme for
action is to influence future policy development across government
departments and throughout the wider public sector, and bring
about changes in behaviour in organisations and individuals....
Together we can work our way to better mental health.’

– Working Our Way to Better Mental Health

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‘Our vision is one where having a mental
health condition is no longer stigmatising
nor a barrier to full and equal participation
in our society. We must rethink how we
work and challenge negative assumptions
about mental health conditions.’
- Work, Recovery and Inclusion

The National Mental Health Development Unit (NMHDU) is the

agency charged with supporting the implementation of mental health
policy in England by the Department of Health in collaboration with
the NHS, Local Authorities and other major stakeholders.
Designed by Richard P Chapman Design Associates

Wellington House (Area 305)

133-135 Waterloo Road
London SE1 8UG
T 0207 972 4803
E ask@nmhdu.org.uk
W www.nmhdu.org.uk/psa16

Printed on recycled paper

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